1. Episode 2-Academic/Students: New UC Benefits Eligibility Rules
Episode 2-Academic/Students: New UC Benefits Eligibility Rules UCSB Benefits Revised 2/2017

2. Agenda Review of Episode 1 New Concepts Advanced scenarios
Results of SMP 14/15
Roles and Responsibilities
Resources
IRS Form 1095c

3. Review of Episode 1 Affordable Care Act-ACA
What’s Not Changing for 2016
What is Changing for 2016
New Concepts
Initial & Continuing Eligibility
Scenarios
What is Happening Now

4. Employer Shared Responsibility
Affordable Care Act of 2010
Employer Shared Responsibility
To comply with the ACA, UC is required to change benefits eligibility rules for all employee starting in January 2016.
No category of employees may be excluded
Definition of hours we count must change
New provisions will make it easier for employees to maintain UC coverage
More employees may be offered coverage
There are severe financial penalties for non-compliance

5. What did NOT Change? 1,000 hour rule/ 750 hour rule
Rolling hours toward UCRP (and BELI 1)
System will continue to automatically assign BELI 1 and derive retirement codes
Central Benefits Office coordination
BELI/Benefit Packages
BELI 1, 2, 3, 4
Full, Mid-Level and Core
BELI 5
No benefits
BELI P – Postdoctoral Scholars

6. What Changed? Employee takes no action during their PIE
NO automatic default into Core medical, Delta Dental or VSP
Automatic enrollment into Core/Basic Life and Short-term Disability (if applicable)
The period of time an employee can remain enrolled
Stability Period = Year-to-year

7. Eligibility Eligible Categories
Group A : Appointment Types 1, 2, 3, *5, 7, & 8
*Appt Type 5 –excluding academic student title codes
Group B:
Appointment Types 4, 6 and *5
Positions paid flat rate pay (BYA, SST)
*Appt Type 5- academic student title codes
Ineligible Categories
None
Eligibility Requirements
Group A – varies
Group B- 30 average weekly hours for 3 months or more

8. Continuing Eligibility
Continuing Eligibility Measurement Method
Average weekly hours of service calculated annually using a 12-month look-back period
Continuing Eligibility: Measurement Timeframe
Standard, 12-month look-back period
Monthly: Nov 1 – Oct 31
Biweekly: Nov 8 – Nov 5 (varies year to year)

9. Hours worked Hours included in calculation to determine eligibility
“Average Hours of Service”
All paid time, for example: summer salary pay, overtime.
UNPAID TIME
Unpaid Jury Duty
Unpaid Hours during “special employment breaks” of at least 4 weeks (up to 501 hours max)
Hours excluded
Work study
Hours worked under title codes 4329 & 9920

11. New Concepts-revised (see handout)
Group A and Group B
Benefit Coverage Periods
Beginning Benefits Eligibility Period
Stability Period
Measurement Periods
Initial Measurement Period
Standard Measurement Period
BYH DOS code

12. New Concepts-continued
Employment Breaks * new
a period of at least four consecutive weeks during which an employee of an educational organization does not work.
UC must credit the employee up to 501 hours in calculating average hours for determining eligibility at the time of measurement. (manual process)
Less than 26 weeks (see New Concepts document for details)
More than 26 weeks- treat as a new employee

13. BYH Information
BYH DOS code has been added to PPS in order to attribute hours of service for “flat dollar-paid” employees as the result of the ACA
Any employee solely with a Flat dollar paid appt such as BYA and zero hours during the measurement period will be automatically offered the CORE Benefits Package.
BYH DOS code does NOT generate pay;
BYH does not impact any other accumulations, such as the 1,000 hours toward benefits eligibility, vacation or sick leave accruals, career status, etc.
(student visa requirements may be impacted)

14. BYH Information, cont’d
BYH instructions can be found on the following link, under PPS Tools and Resources.
0.4000

16. Group A & B: Initially Eligible & Continuing Eligibility
If eligibility is awarded on DOH, it will continue until December 31 of the year following the first complete standard measurement period in which average hours of service per week is less than 17.5/30 hours; then subject to Standard Measurement
Nov 2014
Dec 2014
Jan 2015
Feb 2015
March 2015
April 2015
May 2015
June 2015
July 2015
Aug 2015
Sept 2015
Oct 2015
Nov 2015
Dec 2015
Jan 2016
Feb 2016
March 2016
April 2016
May 2016
June 2016
July 2016
Aug 2016
Sept 2016
Oct 2016
Nov 2016
Dec 2016
Jan 2017
Feb 2017
Mar 2017
April 2017
May 2017
June 2017
July 2017
Aug 2017
Sept 2017
Oct 2017
Nov 2017
Dec 2017
DOH 4/1/2015 BELI 1-4
Beginning Benefits Eligibility (BBE)
2017 Stability Period
Standard Measurement Period
Standard Measurement Period
Standard Measurement Period
Measured here for elig. Meet threshold, benefits continue for If not, benefits end 12/31/2016
Measured here for eligibilty. Meet threshold benefits continue for If not, benefits end 12/31/2017
Not measured for elig until employed for entire standard measurement period

17. GROUP A and B : Not Eligible on Date of Hire
Initially IN-ELIGIBLE, BELI 5 on DOH. Start the Initial measurement period beginning on DOH
A change in status during initial measurement period (increase in hours worked, etc.) such that the employee now qualifies.
Effective May 1, 2016 update BELI and start BBE.
Employee is not measured until Nov 2017 when they have completed a SMP as BELI 4
Nov 2014
Dec 2014
Jan 2015
Feb 2015
March 2015
April 2015
May 2015
June 2015
July 2015
Aug 2015
Sept 2015
Oct 2015
Nov 2015
Dec 2015
Jan 2016
Feb 2016
March 2016
April 2016
May 2016
June 2016
July 2016
Aug 2016
Sept 2016
Oct 2016
Nov 2016
Dec 2016
Jan 2017
Feb 2017
Mar 2017
April 2017
May 2017
June 2017
July 2017
Aug 2017
Sept 2017
Oct 2017
Nov 2017
Dec 2017
DOH 4/1/2015, BELI 5
Initial Measurement Period
BELI 4 BBE
Standard Measurement Period
Standard Measurement Period
Standard Measurement Period
SMP: Measure here. If eligible, update BELI and provide BBE.
Not
Measured for elig
Measured here for elig
Not measured for elig
BELI 4
Eff

18. Example: Lecturer/varying percentages/750 hours
July 1, 2015: Average equals 66% so assigned a BELI 2
March 15, 2016: Reaches 750 hrs and becomes a BELI 1 on 4/1/2015. Reset BBE
July 1, 2016: Lecturer reappointed at 33% for Fall/Winter and Spring
Nov 1, 2016: Not measured because employee has not completed the SMP as BELI 1
Nov. 1, 2017: Measured. No longer meets the eligibility, benefits end
July 1, 2015
Aug 2015
Sept 2015
Oct 2015
Nov 2015
Dec 2015
Jan 2016
Feb 2016
Mar 2016
Apr 2016
May 2016
June 2016
July 2016
Aug 2016
Sept 2016
Oct 2016
Nov 2016
Dec 2016
Jan 2017
Feb 2017
Mar 2017
Apr 2017
May 2017
June 2017
July 2017
Aug 2017
Sept 2017
Oct 2017
Nov 2017
Dec 2017
Jan 2018
Standard Measurement Period
Standard Measurement Period
SMP
BELI 2 BBE
BELI 1 BBE
BELI 2
DOH 7/1/2015, 67%-33% & 100% Fall
Reappointed at 33% for the fiscal year
BELI 1
750 hours
Measure here for elig
Not measured for elig
Not measured

20. Advance Scenarios WOS Summer Session Moving between Groups
Rehires/26 week rule
Employment Breaks
LISA

21. Example: Paid Appt to Without Salary (WOS)
Nov. 1, 2015: Hired with BELI 1 status
Nov. 2016: Measured for 2017 eligibility; avg. hours are above17.5; Benefits continue for entire 2017 Benefits Stability Period (as long as employed)
March 1, 2017: Paid appt ends and “WOS” appt is entered. “WOS is now considered a Grp B category. BELI changes to BELI 4 with new effective date. Employee can enroll and prepay Core benefits (UC & EE contributions) or elect not to enroll.
Oct. 1, 2017: Returns to paid appt. Review benefits eligibility and assign the applicable BELI.
Nov 2018: Measured here for eligibility. Include average hours up to 501 for calculating the average
Nov 2015
Dec 2015
Jan 2016
Feb 2016
March 2016
April 2016
May 2016
June 2016
July 2016
Aug 2016
Sept 2016
Oct 2016
Nov 2016
Dec 2016
Jan 2017
Feb 2017
March 2017
April 2017
May 2017
June 2017
July 2017
Aug 2017
Sept 2017
Oct 2017
Nov 2017
Dec 2017
Jan 2018
Feb 2018
Mar 2018
April 2018
May 2018
June 2018
July 2018
Aug 2018
Sept 2018
Oct 2018
Nov 2018
Dec 2018
Standard Measurement Period
Standard Measurement Period
Standard Measurement Period
BELI 1-BBE
Stability Period
Measured for elig
Not measured
Measured for elig
DOH
BELI 1
WOS Appt BELI 4 eff March 1
Returns to paid appt

22. Example: Academic Appt/Summer Session
July 1, 2014: BELI 1 Nov 1, 2015: Measured -completed the SMP as BELI 1
July 1,-Sept : Appointed to Summer Session-flat rate pay-GRP B, assign BELI 4 because in a Stability Period, reset BBE
October 1, 2016 Returns to GRP A appointment and qualifies for BELI 1 reset BBE
Nov. 1, 2016: Not measured-did not complete SMP
Nov 1, 2017: Measured
July 1, 2015
Aug 2015
Sept 2015
Oct 2015
Nov 2015
Dec 2015
Jan 2016
Feb 2016
Mar 2016
Apr 2016
May 2016
June 2016
July 2016
Aug 2016
Sept 2016
Oct 2016
Nov 2016
Dec 2016
Jan 2017
Feb 2017
Mar 2017
Apr 2017
May 2017
June 2017
July 2017
Aug 2017
Sept 2017
Oct 2017
Nov 2017
Dec 2017
Jan 2018
SMP
Standard Measurement Period
Standard Measurement Period
BELI 1 Stability Period
BBE
BELI 4 BBE
BELI 1 BBE
Appointed to SST
BELI 1
Hired in 2014
Not measured
Measure here for elig
Measured here for elig
Return to Lecturer appt

23. Example: Rehire - break in service < 26 weeks
Nov. 1, 2015: Appointed to Career position, 75% indefinitely. Assign BELI 1 starting Nov. 1, 2015
Jan. 31, 2017: Separates; Benefits end
June 1, 2017: Rehired – Limited position, 40% for 10 months. Less than 1,000 hours. Because the break was less than 26 weeks, and the employee previously had a BELI 1-4, they get to return to some level of benefits. If they don’t qualify for anything higher you still have to provide BELI 4
New BELI effective date triggers a new BBE. Employee remains BELI 4 until separated.
Nov 2015
Dec 2015
Jan 2016
Feb 2016
March 2016
April 2016
May 2016
June 2016
July 2016
Aug 2016
Sept 2016
Oct 2016
Nov 2016
Dec 2016
Jan 2017
Feb 2017
March 2017
April 2017
May 2017
June 2017
July 2017
Aug 2017
Sept 2017
Oct 2017
Nov 2017
Dec 2017
Jan 2018
Feb 2018
Mar 2018
April 2018
May 2018
June 2018
July 2018
Aug 2018
Sept 2018
Oct 2018
Nov 2018
Dec 2018
Standard Measurement Period
Standard Measurement Period
Standard Measurement Period
BELI 1-BBE
BELI 1 Stability Period
DOH
BELI 1
BELI 4 BBE
Measured for elig
Not measured
Separated
Rehired-less than 26 wks
Separated

24. Example: Rehire - break in service of more than 26 weeks
Nov. 1, 2015: Appointed to Career position, 100% indefinitely. Assign BELI 1 starting November 1, 2015
Nov. 2016: Measured for 2017 eligibility; avg. hours are above17.5; Benefits continue for entire 2017 Benefits Stability Period (as long as employed)
Feb. 28, 2017: Resigns and is separated; Benefits end 2/28/2017
October 1, 2017: Gets a new job – Limited appointment, 40% for 6 months. Less than 1,000 hours. Because break was more than 26 weeks, treat as a new hire. BELI 5 with IMP
Nov 2015
Dec 2015
Jan 2016
Feb 2016
March 2016
April 2016
May 2016
June 2016
July 2016
Aug 2016
Sept 2016
Oct 2016
Nov 2016
Dec 2016
Jan 2017
Feb 2017
March 2017
April 2017
May 2017
June 2017
July 2017
Aug 2017
Sept 2017
Oct 2017
Nov 2017
Dec 2017
Jan 2018
Feb 2018
Mar 2018
April 2018
May 2018
June 2018
July 2018
Aug 2018
Sept 2018
Oct 2018
Nov 2018
Dec 2018
Standard Measurement Period
Standard Measurement Period
Standard Measurement Period
BELI 1-BBE
Stability Period
DOH
BELI 1
Initial Measurement Period
separated
Rehired-BELI 5
measured for elig
Measured for elig

25. Example: BELI P to other benefits package- no break in service
Feb. 1, 2016: Hired as a Post Doc assigned BELI P
Dec 1, 2016: Appt. ends early and is rehired in a Junior Specialist 30% for 2 years. No break in service so we must provide the some level of benefits. However Post Docs have a different benefits package so we can only offer Core benefits. Assign BELI 4
Nov 2017: Not measured because has not completed a SMP as a BELI 4.
Nov 2018: Measured here for Grp B eligibility
Nov 2015
Dec 2015
Jan 2016
Feb 2016
March 2016
April 2016
May 2016
June 2016
July 2016
Aug 2016
Sept 2016
Oct 2016
Nov 2016
Dec 2016
Jan 2017
Feb 2017
March 2017
April 2017
May 2017
June 2017
July 2017
Aug 2017
Sept 2017
Oct 2017
Nov 2017
Dec 2017
Jan 2018
Feb 2018
Mar 2018
April 2018
May 2018
June 2018
July 2018
Aug 2018
Sept 2018
Oct 2018
Nov 2018
Dec 2018
Standard Measurement Period
Standard Measurement Period
Standard Measurement Period
BELI P-BBE
DOH
BELI P
BELI 4 BBE
Not Measured for eligibility
Not measured for eligibility
Hired in a Junior position
Measured for eligibility

26. Example: Group B to Group A
Feb. 1, 2016: Hired in a Student position at 75% for 10 months-BELI 4. Appt. ends
Dec 1, 2016: Rehired in a limited position at 30% for 1 year. No break in service so we must provide some level of benefits. Grp A provides Core so we are able to continue with the Core benefits but update the BELI effective date to match the Grp A appointment.
Nov. 2017: Not measured. Have not completed an SMP under Grp A eligibility.
Nov. 31, 2017: Employee is separated
Nov 2015
Dec 2015
Jan 2016
Feb 2016
March 2016
April 2016
May 2016
June 2016
July 2016
Aug 2016
Sept 2016
Oct 2016
Nov 2016
Dec 2016
Jan 2017
Feb 2017
March 2017
April 2017
May 2017
June 2017
July 2017
Aug 2017
Sept 2017
Oct 2017
Nov 2017
Dec 2017
Jan 2018
Feb 2018
Mar 2018
April 2018
May 2018
June 2018
July 2018
Aug 2018
Sept 2018
Oct 2018
Nov 2018
Dec 2018
Standard Measurement Period
Standard Measurement Period
Standard Measurement Period
GRP B-BELI 4-BBE
GRP A- BELI 4 BBE
DOH
BELI 4
Rehired in a limited position
Separated
Not Measured for eligibility
Not measured for eligibility

27. Example: Employment break
April 1, 2016: Hires a GSR at 75% for 3 months or more. BELI 4
June 1, Sept. 30, 2017: no hours worked but not separated.
October 1, 2017: Returns to pay status at 20% and Dept. 2 hires at 10%.
Nov. 2017: Measured because no break in service. Includes crediting average hours at the time of the employment break up to 501 hours. If meets the 30 average hours, BELI 4 continues for 2018.
Nov 2015
Dec 2015
Jan 2016
Feb 2016
March 2016
April 2016
May 2016
June 2016
July 2016
Aug 2016
Sept 2016
Oct 2016
Nov 2016
Dec 2016
Jan 2017
Feb 2017
March 2017
April 2017
May 2017
June 2017
July 2017
Aug 2017
Sept 2017
Oct 2017
Nov 2017
Dec 2017
Jan 2018
Feb 2018
Mar 2018
April 2018
May 2018
June 2018
July 2018
Aug 2018
Sept 2018
Oct 2018
Nov 2018
Dec 2018
Standard Measurement Period
Standard Measurement Period
Standard Measurement Period
BELI 4-BBE
Stability Period
DOH
BELI 4
Measured for elig
Not measured for elig

29. 14/15 Standard Measurement Period results
The first measurement period was from
November 1, to October 31, 2015 for monthly paid employees and
November 8, 2014 to November 5, 2015 for bi-weekly paid employees.
Measured eligible
18 employees on the report, 4 actually eligible
Measured not eligible
61 employees identified on report, 3 will lose coverage (grace period was extended by one month)

30. Roles and Responsibilities

31. Department
Utilizing the BELI Chart, assigns BELI for newly hired, rehired and appointment changes that result in providing higher level of benefits
Receives with list of employees measured eligible
Receives with list of employees measured not eligible.
Assists in researching inquiries from the Benefits office to help confirm eligibility status
Communicates with other departments on shared employees
Contact Kevin Wilson-Smith x:4455 for WOS coordination

32. Department Responsibilities continued
Sends employees to the appropriate resources
NEO
Core Benefits Summary Package
AYS
Attends Episode 3?
Separate your employees and students accordingly

33. HR/Benefits Office
Receives list of employees measured eligible and notifies department
Receives list of employees measured not eligible.
Confirms status.
Mails loss of eligibility letter to the employee using PPS address.
Notifies department representative via
Updates BELI to 5, effective January 1
Benefits end January 31. (received grace period through for our first SMP)
Send COBRA qualifying event to CONEXIS

34. UCOP/Third Party/System
Creates annual SMP reports to determine which employees have measured eligible and ineligible.
Provides the campus with the reports in early December.
HRUnify mails employees, who are measured eligible, letters notifying them of their option to enroll in Core Benefits. Included in the mailing is the Core Benefits Package Summary. Letter is mailed to the address recorded in PPS.
System automatically updates assigned BELI to 4, effective January 1.
Creates a monthly report to measure employees with an Initial Measurement Period (IMP- “anniversary date”). Employee’s who are measured eligible receive a letter/Core Benefits Package Summary, mailed to their address recorded in PPS.
Provides campus with the monthly report
Other reports are pending.

35. Your Resources Benefits Office
General inquires for employees x:2489 or x:4455
General inquires for BELI assistance x:2489 or x:4455
Weird stuff Lisa Romero x:5163
Academic Personnel
Academic Appointments Mayra Magana x:3445
BELI Chart
Episode 2 Powerpoint
HR/Benefits
Ucnet

36. IRS Form 1095
Starting with the 2015 tax year, a new IRS Form 1095C will be issued, as required by the Affordable Care Act (ACA).
By March 31, 2016, members of a University of California-sponsored medical plan will receive Form 1095C, which will be used to document information you provide on your 2015 federal tax return regarding health insurance coverage.
The form(s) will confirm your and your dependents’ coverage for each month of For the 2015 tax year, you will not need to submit the Form 1095C with your income tax return, but you should keep a copy of the form with your important tax documents in the event you need to prove to the IRS that you satisfied the ACA’s “individual mandate” to maintain health insurance coverage for the year.
For questions

37. You did it!

38. Questions? Concerns? Comments? Ideas? Wish list?